US20040260337A1 - Endoscopic instruments and methods of manufacture - Google Patents

Abstract

Embodiments of the invention include a medical device with one or more of a variety of features. More particularly, embodiments of the invention relate to endoscopic devices that include one or more features that improve the use of the device. Examples of such features include chamfered edges and corners on, for example, the end effectors, a surface with a controlled finish also on, for example, the end effectors, a jaw with teeth and/or a tang having various configurations, a handle having soft-grip features, and/or an elongate member with varied rigidity. Other examples of such features include a folded portion on, for example, the end effectors and/or a snap-fit clevis assembly.

Description

CROSS-REFERENCE TO RELATED APPLICATION
• This application is a continuation-in-part of U.S. patent application Ser. No. 10/778,226 to Elliott ROTHBERG, William GIL DE MONTES, James M. ZARDESKAS, David I. FREED, Michael J. MAGILL, Satish SHARMA, Jon GINGRICH, and Edward BOARINI entitled ENDOSCOPIC INSTRUMENTS and filed on Feb. 17, 2004, which claims the benefit under 35 U.S.C. §§119,120 of U.S. Provisional Patent Application No. 60/479,145 to Elliott ROTHBERG and William GIL DE MONTES entitled BIOPSY FORCEPS CUTTER WITH RADIUSED FEATURES and filed on Jun. 18, 2003, the entirety of all of which are incorporated herein by reference.[0001]
DESCRIPTION OF THE INVENTION
• 1. Field of the Invention[0002]
• Embodiments of the invention include a medical device with one or more of a variety of features. More particularly, embodiments of the invention relate to endoscopic devices that include one or more features that improve the use of the device. Examples of such features include chamfered edges and corners on, for example, the end effectors, a surface with a controlled finish also on, for example, the end effectors, a jaw with teeth and/or a tang having various configurations, a handle having soft-grip features, and/or an elongate member with varied rigidity. Other examples of such features include a folded portion on, for example, the end effectors and/or a snap-fit clevis assembly.[0003]
• 2. Background of the Invention[0004]
• Various medical instruments may be used in connection with an endoscope for performing a number of operations at a site deep within a patient's body cavity. One such instrument, a biopsy forceps device, samples tissue from a body cavity with minimal intervention and discomfort to patients. Typically, a biopsy forceps device, like other endoscopic instruments, has a long flexible tubular member for insertion into a lumen of an endoscope. The tubular member is sufficiently long and flexible to follow a long, winding path of the body cavity. An end effector assembly, such as a biopsy forceps assembly, is attached at a distal end of the tubular member, and a handle is attached at a proximal end of the tubular member. The handle may have an elongate portion and a spool portion disposed around the elongate portion. The spool portion may be configured to move longitudinally relative to the elongate portion. An elongate mechanism, such as one or more pull wires, extends through the tubular member to connect the end effector assembly and a portion of the handle, such as the spool portion. Longitudinal movement of the spool portion relative to the elongate portion of the handle causes the elongate mechanism to move longitudinally in the tubular member, which in turn causes the actuation of the end effector assembly.[0005]
• In methods of using the biopsy forceps device, an endoscope is placed in a patient's body cavity adjacent a tissue site from which the acquisition of a tissue sample is desired. The biopsy forceps device is then advanced to the tissue site via a working channel of the endoscope. Once the biopsy forceps device is next to the portion of the tissue from which the acquisition of a tissue sample is desired, the spool portion is moved relative to the elongate portion so as to move pull wires. The movement of the pull wires causes the jaws of the biopsy forceps assembly to open. The open jaws are then advanced to the tissue site, and the spool portion is again moved relative to the elongate portion so as to move the pull wires such that the jaws close. The closing of the jaws causes a tissue sample to be captured in the end effector assembly. The biopsy forceps device is then removed from the body cavity via the working channel of the endoscope.[0006]
SUMMARY OF THE INVENTION
• In accordance with the invention, an embodiment of the invention includes a medical device including a handle, an end effector assembly, and a member connecting the handle to the end effector assembly. The end effector assembly includes an end effector having non-sharp edges and corners.[0007]
• Another embodiment of the invention includes a medical device including a handle, an end effector assembly, and a member connecting the handle to the end effector assembly. Portions of the end effector assembly have a roughened surface.[0008]
• Yet another embodiment of the invention includes a medical device including a handle, an end effector assembly, and a member connecting the handle to the end effector assembly. The end effector assembly includes opposing jaw portions each including a plurality of teeth. Each of the teeth includes a crest, a root, and an intermediate portion between the crest and the root. The intermediate portions of opposing jaw portions are configured to contact each other when the opposing jaw portions are brought together and the root has a recessed portion configured to accommodate a sharp, pointed tip of the crest.[0009]
• Still another embodiment of the invention includes a medical device including a handle, an end effector assembly, and a member connecting the handle to the end effector assembly. The end effector assembly includes at least one end effector having a tang defining a mounting hole configured to receive one of a wire and an axle and the tang includes a portion disposed around the mounting hole that has a thickness greater than a thickness of other portions of the tang.[0010]
• A further embodiment of the invention includes a medical device including a handle, an end effector assembly, and a member connecting the handle to the end effector assembly. The end effector assembly includes at least one biopsy jaw having a tissue receiving portion that defines at least one hole configured so as to substantially prevent contact between an edge of the hole and a tube-like member in which the end effector assembly is configured to extend through.[0011]
• A yet further embodiment of the invention includes a medical device including a soft-grip handle, an end effector assembly, and a member connecting the handle to the end effector assembly.[0012]
• A still further embodiment of the invention includes a medical device including a handle, an end effector assembly, and an elongate, flexible member connecting the handle to the end effector assembly. A proximal portion of a distal third of the elongate member is more flexible than adjacent portions of the elongate member.[0013]
• Another embodiment of the invention includes a medical device including a handle, an end effector assembly, and an elongate, flexible member connecting the handle to the end effector assembly. The end effector assembly includes a pair of opposing biopsy jaws each having a tissue receiving portion having a roughened surface and defining a hole, the hole configured so as to substantially prevent contact between an edge of the hole and a tube-like member in which the end effector assembly is configured to extend through. Each biopsy jaw further includes a tang defining a mounting hole configured to receive one of a wire and an axle, the tang including a portion disposed around the mounting hole that has a thickness greater than a thickness of other portions of the tang. Each biopsy jaw further includes a plurality of teeth, each of the teeth including a crest, a root,.and an intermediate portion between the crest and the root. The intermediate portions of opposing biopsy jaws are configured to contact each other when the biopsy jaws are brought together, and the root has a recessed portion configured to accommodate a sharp, pointed tip of the crest.[0014]
• Various embodiments of the invention may have any or all of the following features: wherein the end effector defines a hole having a non-sharp edge. The end effector may include a jaw extending from an arm, and wherein all edges of the jaw other than a cutting edge of the jaw are non-sharp. The non-sharp edges and corners may be beveled. Portions of the end effector assembly may have a rougher surface than other portions of the end effector assembly. The end effector assembly may include a biopsy forceps jaw having a roughened surface. The roughened surface of the biopsy forceps jaws may be an outer surface of the biopsy forceps jaw. The roughened surface of the biopsy forceps jaws may be an inner surface of the biopsy forceps jaw. The roughened surface may be formed by one of grit blasting, media tumbling, plating, sputtering, photo-etching, acid-etching, and plasma coating. The root may be at least a partial, substantially circular cutout. A center of the cutout may be displaced vertically relative to adjacent intermediate portions. A center of the cutout may be displaced horizontally relative to a center of adjacent intermediate portions. The root may be a U-shaped groove. A center of the U-shaped groove may be displaced vertically relative to adjacent intermediate portions. A center of the U-shaped groove may be displaced horizontally relative to a center of adjacent intermediate portions. A gap may be between the tip and the root of opposing teeth when the opposing jaw portions are brought together. A wire having a first wire portion may be substantially contacting one side of the tang and a second wire portion substantially contacting another side of the tang. The at least one end effector may include two end effectors. The wire may be bent on both sides of the mounting hole. A section of the tang defining a through hole may be folded so that the through hole is substantially aligned with the mounting hole. The at least one end effector may define a second mounting hole configured to receive the other of the wire and the axle, and wherein the tang includes a second portion around the second mounting hole that has a thickness greater than the thickness of other portions of the tang. The hole may be disposed off a centerline of the biopsy jaw. The at least one biopsy jaw may include two biopsy jaws. The at least one hole may include a plurality of holes. The handle may have a ring portion connected to an elongate portion, and a spool portion disposed around the elongate portion, and wherein the ring portion and the spool portion have a soft-grip configuration. The handle may have a plurality of finger rings, and wherein the finger rings have a soft-grip configuration. The soft-grip handle may include a low durometer material. The soft-grip handle may include at least one of santoprene and urethane.[0015]
• A further embodiment of the invention includes an end effector assembly for a medical instrument. The end effector assembly includes an end effector having a tang defining a pivot hole. An edge of the tang proximal to the pivot hole extends within an outer periphery of the tang.[0016]
• Still another embodiment of the invention includes a medical device. The medical device includes a handle, an end effector assembly, and a member connecting the handle to the end effector assembly. The end effector assembly includes an end effector having a tang defining a pivot hole. An edge of the tang proximal to the pivot hole extends within an outer periphery of the tang..[0017]
• Various embodiments of the invention may have any or all of the following features: the tang may be configured to substantially prevent contact between the edge and a channel in which the end effector assembly is configured to extend through, as the end effector pivots about the pivot hole; a section of the tang at the outer periphery adjacent the edge may have a smooth surface; a first tang portion extending from the outer periphery to the edge may form less than a[0018]90 degree angle to a second tang portion extending from the outer periphery and defining the pivot hole; the first tang portion and the second tang portion may form an approximately zero degree angle; the first tang portion and the second tang portion may be substantially parallel; a section of the tang between the outer periphery adjacent the edge and the edge may be curved; the edge may be substantially sharp.
• A still further embodiment of the invention includes a clevis assembly for a medical instrument. The clevis assembly includes a clevis having a base and a first arm and a second arm extending from the base and an axle extending between the first arm and the second arm. The axle defines a groove in which a portion of the first arm is disposed.[0019]
• Yet another embodiment of the invention includes a clevis assembly for a medical instrument. The clevis assembly includes a clevis having a base and a first arm and a second arm extending from the base and an axle extending between the first arm and the second arm. A portion of the first arm is configured to deflect from an original configuration and return to the original configuration as the axle is placed through the first arm.[0020]
• A yet further embodiment of the invention includes a medical instrument. The medical instrument includes a handle portion, an end effector assembly, and an elongate member connecting the handle portion to the end effector assembly. The end effector assembly includes a clevis having a base and a first arm and a second arm extending from the base and an axle extending between the first arm and the second arm. The axle defines a groove in which a portion of the first arm is disposed.[0021]
• Another embodiment of the invention includes a medical instrument. The medical instrument includes a handle portion, an end effector assembly, and an elongate member connecting the handle portion to the end effector assembly. The end effector assembly includes a clevis having a base and a first arm and a second arm extending from the base and an axle extending between the first arm and the second arm. A portion of the first arm is configured to deflect from an original configuration and return to the original configuration as the axle is placed through the first arm.[0022]
• Various embodiments of the invention may have any or all of the following features: the portion may be configured to deflect from an original configuration as the axle is placed through the first arm; the portion may be configured to substantially return to the original configuration for disposition in the groove; the portion may include a plurality of protrusions defining a hole in the first arm; the protrusions may deflect; the second arm may define a hole, and a portion of the axle at an end opposite the groove may be configured to prevent passage of the portion of the axle through the hole; an end of the axle may have a larger circumference than a central portion of the axle; and the axle may include end portions having cross-sectional sizes larger than a hole defined by the portion of the first arm.[0023]
• A further embodiment of the invention includes a method of manufacturing an end effector assembly of a medical instrument. The method includes providing a clevis having a base and a first arm and a second arm extending from the base, providing an axle, placing an axle through the second arm, placing the axle through the first arm so as to deflect a portion of the first arm, and returning the portion of the first arm to its original configuration.[0024]
• Various embodiments of the invention may have any or all of the following features: the portion of the first arm in a groove on the axle; providing an end effector; placing the axle through a portion of the end effector.[0025]
• Additional objects and advantages of the invention will be set forth in part in the description which follows, and in part will be obvious from the description, or may be learned by practice of the invention. The objects and advantages of the invention will be realized and attained by means of the elements and combinations particularly pointed out in the appended claims.[0026]
• The foregoing general description and the following detailed description are exemplary and explanatory only and are not restrictive of the invention, as claimed.[0027]
BRIEF DESCRIPTION OF THE DRAWINGS
• The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate embodiments of the invention and together with the description, serve to explain the principles of the invention.[0028]
• FIG. 1 is a perspective view of an endoscopic instrument suitable for use in connection with embodiments of the present invention.[0029]
• FIG. 2 is a perspective view of a jaw portion of an endoscopic instrument.[0030]
• FIG. 3 is a perspective view of a jaw portion of an endoscopic instrument according to an embodiment of the present invention.[0031]
• FIG. 4 is a schematic view of an endoscopic instrument with an elongate member of variable flexibility according to an embodiment of the present invention.[0032]
• FIG. 5 is a perspective view of a jaw assembly of an endoscopic instrument according to an embodiment of the present invention.[0033]
• FIG. 6 is a perspective view of a jaw assembly of an endoscopic instrument according to an embodiment of the present invention.[0034]
• FIG. 7 is a view of a jaw portion of the jaw assembly of FIG. 6.[0035]
• FIG. 8A is a side view of mated jaw portions of an endoscopic instrument.[0036]
• FIG. 8B is a side view of mated jaw portions of an endoscopic instrument.[0037]
• FIG. 9 is a side view of a jaw portion of the jaw assembly of FIG. 6.[0038]
• FIG. 10 is a side view of the mated jaw portions of FIG. 9.[0039]
• FIG. 11 is a side view of a jaw portion of an endoscopic instrument according to another embodiment of the present invention.[0040]
• FIG. 12 is a side view of a jaw portion of an endoscopic instrument according to yet another embodiment of the present invention.[0041]
• FIG. 13 is a top view of a tang portion and control wire of an endoscopic instrument.[0042]
• FIG. 14 is a top view of a tang portion and control wire of an endoscopic instrument according to an embodiment of the present invention.[0043]
• FIG. 15A is a side view of a jaw with a tang portion, having an unfolded additional section, of an endoscopic instrument according to another embodiment of the present invention.[0044]
• FIG. 15B is a perspective view of the jaw with the tang portion of FIG. 15A, with the additional section folded.[0045]
• FIG. 16 is a side view of a handle of an endoscopic instrument according to an embodiment of the present invention.[0046]
• FIG. 17 is a side view of a handle of an endoscopic instrument according to another embodiment of the present invention.[0047]
• FIG. 18A is a side view of a tang portion of a jaw according to a further embodiment of the present invention.[0048]
• FIG. 18B is a cross-sectional view of the tang portion of FIG. 18A along[0049]line18B-18B.
• FIG. 18C is a cross-sectional view of a tang portion of a jaw according a still further embodiment of the present invention.[0050]
• FIG. 18D is a cross-sectional view of a tang portion of a jaw according a yet further embodiment of the present invention.[0051]
• FIG. 19A is a perspective view of a clevis assembly according to yet another embodiment of the present invention.[0052]
• FIG. 19B is a side view of an axle of the clevis assembly of FIG. 19A.[0053]
• FIG. 19C is a partial side view of a portion of the clevis assembly of FIG. 19A.[0054]
• FIG. 19D is a schematic view of the clevis assembly of FIG. 19A.[0055]
• FIG. 19E is a schematic view of the clevis assembly of FIG. 19A, with the axle being inserted into the clevis.[0056]
• FIG. 20A is a side view of a clevis according to still another embodiment of the present invention.[0057]
• FIG. 20B is a schematic view of an axle in the clevis of FIG. 20A.[0058]
• FIG. 20C is a schematic view of the axle and clevis of FIG. 20A.[0059]
DESCRIPTION OF THE EMBODIMENTS
• Reference will now be made in detail to the present exemplary embodiments of the invention illustrated in the accompanying drawings. Wherever possible, the same reference numbers will be used throughout the drawings to refer to the same or like parts.[0060]
• An exemplary embodiment of a medical device is depicted in FIG. 1. The medical device is an[0061]endoscopic instrument10 that includes ahandle portion11 and anend effector assembly12 connected to each other by a flexibleelongate member13.Control wires14,15 extend between thehandle portion11 and theend effector assembly12 via a lumen in the flexibleelongate member13. Thehandle portion11 includes anelongate portion16 connected at its proximal end to aring portion17 and aspool portion18 slidably disposed around theelongate portion16. Theelongate member13 may having a coiled portion19 (partially shown in FIG. 1) covered by an outer jacket or asheath27. However, theelongate member13 may not have a coiledportion19, and instead may include a single layer tubular member. Theend effector assembly12 may be any type of assembly, for example, a biopsy forceps jaw as depicted in FIG. 1. Thecontrol wires14,15 may be connected at their distal ends to opposing portions of theend effector assembly12, and at their proximal ends tospool portion18. Longitudinal movement of thespool portion18 relative to theelongate portion16 causes the actuation of theend effector assembly12 via thecontrol wires14,15. Portions of thecontrol wires14,15 disposed in thehandle16 may be contained within a tube also disposed in thehandle16. The tube may provide the compressive strength that may be needed to actuate theend effector assembly12.
• A current[0062]biopsy forceps jaw30, such as that shown in FIG. 2, includes ajaw32 extending from anarm34.Jaw32 includes a sharp edge orteeth35 at its cutting edge.Teeth35 may mate with another biopsy forceps jaw, of like or similar construction, of an endoscopic forceps instrument to obtain a biopsy sample.Jaw32 also includes flat surfaces on various parts ofjaw32. For example, the back orproximal-most surface36 ofjaw32 and certain surfaces intersecting withsurface36 may be flat. The intersection of those surfaces will result in sharp corners and edges, such asedges38 andcorners40.Jaw32 also defines afenestration hole42 that may include asharp edge44. Many current biopsy forceps jaws have such a construction because they are cast from a molded plastic pattern. Certain efficiencies in the manufacture of injection molds lead to flat, intersecting planes and sharp edges and corners of the resultant jaws. These sharp edges and corners, however, may get caught within an endoscope working channel upon entry or exit of a biopsy forceps device through that channel or at the distal end of the endoscope upon re-entry of the forceps after use.
• Embodiments of the invention include a medical device or portions of the medical device with chamfered corners and/or edges. FIG. 3 shows a[0063]biopsy forceps jaw50 according to an exemplary embodiment of the present invention. Thebiopsy forceps jaw50 includes ajaw52 extending from anarm54. Likejaw32 of FIG. 2,jaw52 includes a sharp edge orteeth55 at a cutting edge. Unlikejaw32, however, certain surfaces ofjaw52 are not substantially flat and, instead, are rounded at least near the edges of those surfaces. The corners and edges of various intersecting surfaces are therefore chamfered, beveled, rounded, and/or radiused off and not sharp. For example, the back orproximal-most surface56 ofjaw52 and certain surfaces intersecting withsurface56 are rounded at least near the edges of those surfaces so that there are no, or fewer, sharp edges or corners associated with jaw32 (other than the sharp cutting edge having teeth).Jaw52 also defines afenestration hole62 that may include anedge64 that is rounded, chamfered, beveled, and/or radiused, off so that there is not a sharp edge. The resulting jaw will have no, or fewer, sharp edges or corners to catch within an endoscope working channel upon entry or exit of a biopsy forceps device through that channel or at the distal end of the endoscope upon re-entry of the forceps after use. Less interference with at least the distal section of the endoscope results.
• Providing a medical device, or portions thereof, with non-sharp edges and corners may apply to other types of end effectors or other parts of endoscopic or non-endoscopic instruments, including, but not limited to graspers, scissors, forceps, or other laproscopic, endoscopic, or other devices. For example, the medical device may have a sharp cutting edge that is a radial edge (i.e., a straight cutting edge with no teeth). Other edges, corners, and surface intersections, aside from those mentioned above, may be rounded, chamfered, beveled, and/or radiused off as desired to minimize the effects associated with sharp regions as the device is being used. For example, other portions of the end effector assembly, including tang portions, clevis portions, and/or axle portions may include rounded, chamfered, beveled, and/or radiused off edges and corners.[0064]
• Embodiments of the invention include a medical device or portions of the medical device having a controlled surface finish, including a roughened surface finish. FIG. 5 shows the[0065]inner surface72 andouter surface71 of a biopsyforceps jaw assembly70 having a rough surface finish. While FIG. 5 shows a biopsyforceps jaw assembly70 having all parts with a roughened surface, less than all of the parts of thejaw assembly70 may include a roughened or textured surface. For example, to attain many of the advantaged described herein, it may be desirable for only thejaws73, or portions of thejaws73 such as theouter surface71, to have a roughened or otherwise textured surface.
• Tissues are less prone to sticking to surfaces of jaws having a rough finish than surfaces of jaws having a smooth finish. For example, tissue samples cut with the roughened[0066]jaws73 may be less prone to sticking to thesurfaces71,72 of thejaws73. By lessening the smoothness of theinner surface72 of thejaws73, the tissue sample may be more easily removed from thejaws73, for example, when the tissue sample is discharged into an external container.
• One potential advantage of having a controlled roughness on the surface of the jaws is that by reducing the amount of sticking, surface contact, and/or seal between the tissue samples and the biopsy jaws, the amount of time spent in a biopsy tissue acquisition procedure is reduced. For example, the amount of time spent trying to release the surface contact between the tissue samples and the surfaces of the jaws, during multiple sample acquisition and/or removing the samples from the jaws into an external specimen container, is reduced. This may permit faster turnaround when a single bite biopsy forceps assembly needs to be removed from an endoscope, the tissue sample retrieved from the jaw, and the assembly reinserted into the endoscope to obtain a subsequent sample.[0067]
• Another potential advantage for having a rough finish on the surface of the endoscopic instrument is that it reduces surface contact between jaws and/or prevents surfaces of the jaws from sealing and/or sticking to each other. Smooth surfaces may sometimes stick together and form a seal, particularly if a fluid is placed between the surfaces. Having a rough finish on the surface of the jaws reduces the force with which that particular surface of the jaws will stick to either each other or another surface. For example, the surfaces of the teeth of opposing jaws may be less prone to sticking to each other when brought together.[0068]
• Yet another potential advantage for controlling the surface finish of an endoscopic instrument is that it may provide a more consistent feel and/or performance to the user. For example, the entire endoscopic instrument may have a particular finish, or portions of the endoscopic instrument, such as the end effectors, may have different finishes.[0069]
• A further potential advantage for controlling the surface finish of an endoscopic instrument is that, for example, when an optimum level of roughness is provided to the surface of the jaw assembly, tissue is more readily grasped and retained in the jaws, for example, so that multiple samples may be collected with a single bite forceps. The controlled surface texture may allow a user to obtain subsequent tissue samples with the prior sample(s) remaining within the jaws. A particular texture of the jaws may allow the tissue sample to be retained within the open jaws while the user acquires a second sample.[0070]
• A still further potential advantage for controlling the surface finish of an endoscopic instrument is that, for example, when an optimum level of roughness is provided to the surface of the jaw assembly, the roughened surface may assist in both retaining and removing the sample. Such assistance may be dependent on the presence or absence of an external force. For example, when there is no external force exerted on the sample, the roughened surface may assist in the retention of the sample. In another example, when an external force is applied to the sample, the roughened surface may assist in the removal of the sample.[0071]
• The roughness of the[0072]surfaces71,72 of thejaw assembly70 may be created and/or adjusted, for example, by controlling the casting of thejaws73 and/or subsequent processing of thejaw assembly70. Subsequent processing may including grit blasting, media tumbling, and/or any other suitable surface finishing technique. Thesurfaces71,72 of thejaw assembly70 could also be plated, sputtered, photo-etched, acid-etched, and/or plasma coated to control the roughness of the surface. The surface or surfaces of the endoscopic instrument may have a roughness in the range of a few hundred microinches, and may be varied, for example, by increments of a few hundred microinches. The relative roughness of the surface or surfaces of the endoscopic instrument may be varied with respect to each other. For example, one surface or portion of a surface may have a relatively rough finish, while another surface or portion of a surface may have a relatively smooth finish.
• Providing surface(s) of a medical device, or portions thereof, with a controlled finish, for example a roughened surface, may apply to other types of end effectors or other parts of endoscopic or non-endoscopic instruments, including, but not limited to graspers, scissors, forceps, or other laproscopic, endoscopic, or other devices. Furthermore, other portions of the end effector assembly, including tang portions, clevis portions, and/or axle portions may include surfaces with a controlled finish, for example, a roughened surface. Additionally, only specific portions of parts of the end effector assembly may have a controlled finish. For example, only the inner surfaces of a the jaws of an end effector assembly may have a roughened surface.[0073]
• Views of mated[0074]jaw portions83 of endoscopic instruments are shown in FIGS. 8A and 8B. Eachjaw portion83 hasteeth84, with eachtooth84 having acrest portion88. Aroot portion89 is disposed between each set of adjoiningteeth84. Substantiallydiagonal portions90 of theteeth84 are disposed between thecrest88 and theroot89 to form the tooth.
• The configuration of the[0075]root89 may limit the configuration of the teeth. For example, in order for opposingteeth84 to fit together, the substantiallydiagonal portions90 ofteeth84 on opposingjaw portions83 need to meet before thecrest88 contacts theroot89. Otherwise, agap91 will form between the substantiallydiagonal portions90 of opposingjaw portions83, as shown in FIG. 8A. Thegap91 may prevent the opposingjaw portions83 andteeth84 from performing an effective cutting action. Though FIG. 8A includesjaws83 havingteeth84 with sharp tips to enhance biting action, it may be difficult to fabricate jaws (such as through stamping) that have matching sharp-corneredroots89.
• In some cases, to ensure the opposing[0076]jaws portions83 fully close, as shown in FIG. 8B, thecrest portion88 may be given a radius (about 0.005 inches) slightly larger than the radius of the root portion89 (such as about 0.003 inches). Agap92 is formed between thecrest portion88 of onejaw portion83 and theroot portion89 of an opposingjaw portion83. However, this jaw configuration includes teeth with non-sharp tips (i.e. crests) inhibiting optimal cutting performance.
• Embodiments of the invention include a medical device having jaws with various tooth and/or teeth configurations that overcome one or more of the drawbacks. A[0077]jaw assembly180 according to an exemplary embodiment of the invention is depicted in FIGS. 6, 7, and9. Thejaw assembly180 includes aclevis181 configured to be connected to the end of anelongate member13. Opposingjaws182 are rotatably attached to the distal end of theclevis181. Eachjaw182 has ajaw portion183 connected to atang portion184 with mountingholes185 on the proximal end of thetang portion184. Theholes185 may be configured to receive and/or retain awire15 or other interface device via theclevis181. Eachtang portion184 also has anaxle hole186 configured to receive anaxle187 that may be connected to theclevis181. Eachjaw portion183 has a plurality ofteeth184 configured to mate with the plurality ofteeth184 disposed on an opposingjaw portion183. Material may be removed from theroot189 of adjoiningteeth184 so that, for example, sharper teeth (i.e., crest portions with smaller or no radii) may be used. As shown in FIG. 9, theroot189 has a circular cutout below the point where thecrest188 of an opposingjaw portion183 would be captured, regardless of the sharpness of the crest188 (i.e., thecrest188 may have a substantially zero radius). An example of such a configuration is depicted in FIG. 10. Accordingly, thecrest188 may be as sharp as desired, while still allowing the substantiallydiagonal portions190 of opposingjaw portions183 to come into contact with each other. Methods of sharpeningteeth184 such that thecrest188 has a substantially zero radius are known in the art (e.g., stamping, filing, casting). Thisjaw portion183 configuration is advantageous as asharper crest188 results in a sharper tooth with an improved bite performance.
• In various embodiments, the cutout portions of the root may have any shape or configuration that permits contact between substantially diagonal portions of opposing jaws that include sharp teeth. For example, FIG. 11 shows a[0078]root289 configuration where the cutout is substantially U-shaped. In another example, FIG. 12 shows aroot389 configuration where the circular cutout is shifted vertically. Eachroot389 has acenter391 that is disposed below the lower end of the substantiallydiagonal surfaces390. In yet another example, the root portion and/or the circular cutout may also be shifted horizontally, so long as the substantially diagonal portions of the opposing jaw portions come into contact with each other without crests contacting the corresponding roots. In various embodiments, there may be a gap between the tip of the crest and the root, however, the tip of the crest may also just touch the lowest point of the root.
• FIG. 13 shows a profile of a[0079]tang portion100 of an end effector assembly for a medical instrument, with awire101 disposed in a mountinghole102 of thetang portion100. The end portion of thewire101 has a roughly Z-shaped configuration so as to lodge thewire101 in thehole102, allow thewire101 to rotate with respect to thehole102, and/or prevent thewire101 from falling out of thehole102. The wire end portion has twobends103 with aninterface portion104 between thebends103 that contacts the internal surface of thehole100. Theinterface portion104 has substantially the same length as the axial length of thehole102 and/or the width of thetang100, for example, to prevent thewire101 from shifting in thehole102 and/or falling out of thehole102. Two methods of forming the roughly Z-shaped configuration (i.e., bends103) include stamping and/or forging astraight wire101 into the roughly Z-shaped configuration, however, any method known in the art may be used. If the Z-shape is formed by-a stamping or forging operation, the minimum length of the interface portion104 (i.e., the portion of the wire between the bends) that may be formed is about 0.015 inches.
• Embodiments of the invention include a medical device having an end effector assembly with various tang configurations. In an exemplary embodiment of the invention, a substantially narrow tang portion may have a widened portion, for example, by placing a[0080]dimple201 on atang portion200 around a mountinghole202. For example, as shown in FIG. 14, thedimple201 may extend from the surface of thetang portion200 and increase the width of thetang portion200. Thedimple201 may be stamped onto thetang portion200 so as to increase the width of thetang portion200. This is advantageous because it allows thetang portion200 and/or the rest of the jaw assembly to have a smaller thickness while still allowing the jaw assembly to accommodate the end portion of thewire101 set forth above. Specifically, it allows the thickness of thetang portion200 without thedimple201 to be reduced, while still allowing thetang portion200 and/or the mountinghole202 to receive and accommodate an end portion of awire101 with aninterface portion104 having a length of about 0.015 inches. For example, if the width of thetang portion200 is about 0.007 inches, adimple201 of about 0.008 inches could be added to thetang portion200 so as to accommodate an end portion of awire101 with aninterface portion104 having a length of about0.015 inches, without the end portion of thewire101 undesirably shifting in and/or falling out of the mountinghole202. This is especially advantageous when manufacturing a stamped jaw (with tang) having a thickness of material that is less than the length of theinterface portion104.
• In various embodiments, the[0081]bends103 need not make the end portion of thewire101 into necessarily a roughly Z-shaped configuration. For example, thebends103 could form the end portion of thewire101 into a roughly U-shaped configuration. In addition, thebends103 may be formed using any method known in the art. Furthermore, thedimples201 may be formed using any method known in the art. For example, material may be soldered on and/or attached to thetang portion200 using an adhesive to form dimples201. Additionally, the thickness of the tang portion need not be increased by placing a dimple, as a portion of the tang portion may be folded over to increase the thickness. For example, in a tang portion manufactured from material having a thickness of about 0.007 inches, folding over the material would create a tang portion with a thickness of about 0.014 inches. FIGS. 15A and 15B described below illustrate this concept as it relates to the axle hole of the jaw. Thedimple201 and/ortang portion200 may be of any desired shape, size, dimensions, and/or configurations. For example, all the dimensions listed above are exemplary only.
• In an exemplary embodiment of the invention, a tang portion of an end effector assembly of a medical device may have a widened and/or thickened portion, for example, by folding over material in a portion of the tang around the axle hole. As shown in FIGS. 15A-15B, a[0082]tang portion110 of an end effector, such as ajaw114, may be formed such that it has anadditional portion111 extending from thetang portion110. Theadditional portion111 has throughhole113 with substantially the same diameter as anaxle hole112 of the rest of thetang portion110. Theadditional portion111 may then be folded over such that the throughhole113 is aligned with theaxle hole112. For example, atang portion110 may be stamped from a material having a thickness of about 0.007 inches. Thus, both thetang portion110 and theadditional portion111 have a width of about 0.007 inches. When folded over, the combined width of thetang portion110 and theadditional portion111 becomes about 0.014 inches. Awider tang portion110, and particularly a longer axle hole (the combinedholes112 and113), may be advantageous because it imparts a wider footprint to the jaw mechanism, which may increase the stability and/or precision of the jaw, for example, during the clamping of opposing jaws.
• In various embodiments, the tang portion may be widened by forming and then folding over multiple additional portions, for example, three additional portions. The width and/or thickness of other portions of a medical device, including other portions of the end effectors and/or end effector assembly, may be increased using this method. The folded-over portion and/or tang portion may be of any desired shape, size, dimensions, and/or configurations. For example, all the dimensions listed above are exemplary only.[0083]
• In another embodiment of the invention, a tang portion of an end effector assembly of a medical device may have a portion configured to substantially prevent contact between an edge of the end effector and, for example, a tube-like member (such as an endoscope channel) in which the end effector assembly is configured to extend through or other external object. For example, in endoscopic applications, the jaws of a biopsy forceps device will follow the curvature of the endoscope. As the jaws pivot within an endoscope channel, the proximal tang behind the pivot may contact the channel wall. Biopsy jaws, including stamped biopsy jaws, may include sharp edges that may damage the endoscope channel.[0084]
• In an exemplary embodiment of the invention, as shown in FIGS. 18A-18D, a[0085]portion152 of thetang150 may be folded over so as to substantially prevent anedge151 of thetang150 from contacting the inside of an endoscope channel. Instead, a smooth folded portion of the tang having a greater area will contact the endoscope channel. Theportion152 may be disposed on a proximal portion of the tang, however, the portion may also be disposed on any other suitable portion of the end effector. As shown in FIG. 18B, theportion152A may be curved, however, theportion152B may also be more sharply folded over as shown in FIG. 18C, or substantially completely folded over as shown in FIG. 18D (i.e., a portion of the folded overportion152C substantially contacts another portion of the tang150) so that theportion152C may be substantially parallel with thetang150.
• The[0086]tang150 may have anouter periphery153 along its entire circumference. At an apex between theportion152 and the rest of thetang150, theouter periphery153 may be the portion of thetang150 that comes into contact with the inside of the endoscope channel, for example, as the end effector pivots about apivot hole154 of thetang150. Theouter periphery153A,153B,153C at that apex is shown on the respective FIGS. 18B-18D, and preferably has a smooth surface.
• In various embodiments, the folded over portion may be folded on any side of the tang and/or may have any desired geometric configuration. For example, the folded over portion may form any desired angle a (see FIG. 18C) with the tang, e.g., more than 90 degrees, less than 90 degrees, and/or substantially 0 degrees. Manufacturing a folded over portion with an angle of more than 90 degrees relative to the remainder of the tang may be easier than manufacturing a folded over portion an angle of less than 90 degrees. However, a folded over portion with a less than a 90 degree angle to the tang may be more effective in substantially preventing contact between a sharp edge of the end effector and the endoscope channel. In examples, the folded over portion may have a substantially rounded shape (e.g., having a constant radius or a variable radius), for example, to present a smooth, non-damaging contact between the tang and the endoscope channel. The folded over portion may have a semi-circular shape of more than[0087]180 degrees, less than 180 degrees, or substantially equal to 180 degrees. In a further example, the tang may have multiple portions configured to substantially prevent contact between an edge of the end effector and the endoscope channel.
• Embodiments of the invention include a medical device with holes in various portions of the medical device, including through the end effectors. For example, as shown in FIG. 7, a jaw[0088]82 of a jaw assembly may havefenestration holes121 in different portions of jaw82. Fenestration holes121 may assist in removing biopsy samples from the jaw82, for example, by allowing fluid to enter the jaw82 through the fenestration holes121, flow between the biopsy sample and the jaw82, and thus allow the biopsy sample to be flushed out of the jaw82. The fenestration holes121 may be disposed off acenterline122 of the jaw82. This may be advantageous as when the jaw82 is placed down a channel, for example the working channel of an endoscope, because the jaw82 may contact the inner wall of the channel substantially along itscenterline122, the channel will not come into contact with the fenestration holes121. This may be desirable, for example, because contact between theholes121 and the channel may cause theholes121 to catch portions of the channel. This may cause damage to the channel and/or prevent the movement of the medical device with respect to the channel.
• In various embodiments, the[0089]holes121 may have any shape, for example, round, circular, oblong, square, and triangular. Theholes121 may also have of any size and have any desired dimensions. There may be any number ofholes121 on any portion of the medical device, but what is disclosed here areholes121 that are not substantially located on thecenterline122 of the medical device and/or portions of the medical device that may come into contact with a channel and/or another object external to the medical device. Theholes121 need not necessarily be on portions of the medical device that completely preclude theholes121 from coming into contact with the channel and/or another object external to the medical device, but may be on a portion where such contact is reduced or minimal relative to other portions of the medical device.
• Embodiments of the invention include a medical device with user-interface portions configured to reduce stress (i.e. force) on the operator. For example, the handle of a medical device (e.g., an endoscopic instrument with a handle portion) may have soft-grip features. The entire handle may comprise the soft-grip features, or portions of the handle may have soft grip features, for example, those portions that accommodate a user's fingers. For example, in a[0090]handle130 comprising aring portion132, anelongate portion131, and aspool portion133 disposed around theelongate portion131, as shown in FIG. 16, the soft-grip features may be incorporated into thering portion132 and/or thespool portion133. In another example, in ahandle140 comprising three-rings141, as shown in FIG. 17, the soft-grip features may be incorporated into one or more of the three rings141. The soft-grip feature may be a low durometer material, for example, santoprene or urethane, incorporated into the medical device. The soft-grip features reduce stress on the operator, for example, by reducing the stress on their hands, and have a more comfortable ergonomic feel. The reduction in stress on the user may allow the user to perform more procedures than with a medical device without the soft-grip features.
• In various embodiments, any soft material may be used as soft-grip features, for example, rubber and/or rubbery thermoplastics. The soft-grip features may be placed on any portion of the medical device, for example, that have the potential to be handled by a user, provided that it does not otherwise interfere with the operation of the medical device. The soft-grip features may also be varied across portions of the device. For example, portions of the device may have different materials with different durometers.[0091]
• Embodiments of the invention include a medical device having portions with variable stiffness. For example, in endoscopic instruments with an elongate member, portions of the elongate member may have variable stiffness. Some portions of the elongate member may be more flexible, for example, to allow the elongate member to be navigated through areas of the body having curves (i.e., tubular regions with greater tortuosity). Because of the flexibility, at least these portions of the elongate member may easily bend around even sharp curves, for example, in the gastrointestinal tract. Other portions of the elongate member may be more rigid, for example, to allow the elongate member to be properly advanced through areas of the body (e.g., tubular regions). Because of the rigidity, at least these portions of the elongate member can be pushed through, for example, the gastrointestinal tract.[0092]
• In an exemplary embodiment of the present invention, FIG. 4 shows an[0093]endoscopic instrument140 with ahandle141 and anend effector assembly142 connected by anelongate member143. Theelongate member143 may have a diameter of about2.4 mm and a length of about350 cm. However, any other dimensions suitable for its intended use are also possible. The entireelongate member143 has a constant strength and feel from its proximal end to distal end, however, aportion144 of the distal third of theelongate member143 proximal to the distal end effector assembly has a lower stiffness than theother portions145 of theelongate member143. Methods of reducing the stiffness of the desiredportion144 of theelongate member143 include reducing the diameter of theelongate member143 in the, targeted area, and/or varying the material used in theelongate member143 such that thelower stiffness portion144 is comprised of a more flexible material than thehigher stiffness portions145.
• In various embodiments, the elongate member may have its rigidity varied along any portion of the elongate member, may have multiple portions with multiple levels of stiffness, and/or may be manufactured using any method known in the art.[0094]
• Embodiments of the invention include a clevis assembly. An exemplary embodiment of a[0095]clevis assembly300 is shown in FIGS. 19A-19E. Theclevis assembly300 may include anaxle310 and aclevis320.
• The[0096]axle310 may be generally elongate in shape and configured to be used withclevis320. Theaxle310 may have acentral portion311 disposed between ends312,313. Thecentral portion311 may be substantially cylindrical in shape and may be configured to be placed through ahole321 on one of thearms322 of theclevis320. Thecentral portion311 may also be configured to accommodate a portion of an end effector assembly, such as the proximal tang portions of biopsy jaws.
• One[0097]end313 of theaxle310 may be configured to prevent theend313 from being placed through thehole321 on theclevis arm322. Theend313 may include an enlarged head with a shoulder. The head may be substantially hemispherical in shape, however, theend313 may also have any suitable shape or configuration to prevent its extension through thehole321.
• The[0098]end312 may be substantially round in shape, and may have agroove314 that separates theend312 from thecentral portion311. Thegroove314 may extend all the way around theaxle310, and may be configured to receive a portion of one or more of the protrusions, or cantilever arms,323 extending around ahole326 defined by anotherclevis arm324.
• The[0099]clevis320 may have a base325 from whicharms322,324 extend. Thearms322,324 may be substantially similar in shape, however, they may also have different shapes or configurations. Onearm322 hashole321 configured to accommodate a portion ofaxle310, for example, thecentral portion311 ofaxle310. Anotherarm324 has ahole326 with a non-uniform edge327 that is defined by one ormore protrusions323. Theprotrusions323 may each have substantially the same shape, or may have different shapes and/or configurations (e.g., spacing). Theholes321,326 may be substantially coaxial. The portion of thearm324 defining thehole326 may be configured to bend or deflect asaxle310 is placed through thehole326. For example, as shown in FIG. 19E, theprotrusions323 may deflect away from thearm322 asend312 of theaxle310 is placed through thehole326. The portion of thearm324 defining thehole326 may also be configured to substantially return to its original configuration. For example, once theend312 of theaxle310 has been placed through the hole326 a suitable amount, theprotrusions323 may deflect or spring back toward thearm322 and at least a portion of theprotrusions323 may become lodged ingroove314.
• The portion of the[0100]arm324 not defining thehole326 and/orprotrusions323 may be configured to be rigid enough such that thearm324 does not substantially bend or deflect while theprotrusions323 bend or deflect as theend312 of theaxle310 is placed through thehole326. For example, the portion of thearm324 not defining thehole326 may be thicker than theprotrusions323. The base325 may also be configured to be more rigid than thearms322,324, for example, so as to not substantially bend or deflect while theprotrusions323 may bend or deflect as theend312 of theaxle310 is placed through thehole326. In another example, the portion of thearm324 not defining thehole326 and/orprotrusions323 may not have any particular configuration or rigidity such that thearm324 does not substantially bend or deflect while theprotrusions323 bend or deflect as theend312 of theaxle310 is placed through thehole326. For example,arm324 may simply have roughly the same thickness, rigidity, and/or metallic properties as the rest of theclevis assembly300. In such cases, tooling may be used to prevent deflection of thearm324. For example, thearm324 may be placed between grippers, vices, or any other suitable tooling known in the art so as to substantially prevent deflection of thearm324 in a direction substantially perpendicular to the surface of thearm324 and/or substantially parallel to the longitudinal axis of the axle311 (e.g., when theend312 of theaxle310 is placed through thehole326 and exerts force on the protrusions323).
• Another exemplary embodiment of a clevis assembly[0101]400 is shown in FIGS. 20A-20C. The clevis assembly400 may include anaxle410 and aclevis420.
• The[0102]axle410 may have twoends411,412 disposed around acentral portion413. Thecentral portion413 may be substantially cylindrical in shape and may be configured to be disposed inholes421,422 onarms423,424 on theclevis420. Thecentral portion413 may also be configured to accommodate a portion of an end effector assembly, such as the proximal tang portions of biopsy jaws.
• The ends[0103]411,412 may have a generally rounded shape and may be configured to prevent theends411,412 from being placed through at least one of theholes421. For example, theends411,412 may include an enlarged head and a shoulder. The head may be substantially hemispherical in shape, however, theends411,412 may have any suitable shape or configuration. Aninner surface414,415 of theends411,412 may be configured to prevent the rest of theend411,412 from being placed throughholes421,422. Anouter surface416,417, however, may be configured to be placed through at least one of theholes421,422. The ends411,412 may have substantially the same shape and configuration, or may have different shapes and/or configurations. For example, one of theends411,412 may be configured so that it may not be placed through at least one of theholes421,422.
• The[0104]clevis420 may have a base425 from whicharms423,424 extend. Thearms423,424 may have substantially similar shapes, or may have different shapes and/or configurations. One or more of thearms423,424 may define ahole421,422 with one ormore protrusions426A,426B adjacent portions of thehole421,422. Theprotrusions426A,426B may have the same shape, or may have different shapes. Theprotrusions426A,426B may define substantially roundedinner edges427 that are configured, for example, to define portions of a circle. Theprotrusions426A may be configured to deflect towardarm424 asend411 is placed through thehole421. Theprotrusions426B may be configured to deflect away fromarm423 asend411 is placed through thehole422. As shown in FIG. 20C, when anouter surface416 of anend411 of anaxle410 is pressed against theprotrusions426B, theprotrusions426B may deflect as theend411 is advanced throughhole422. Once theend411 has suitably advanced through thehole422, theprotrusions426B may reversibly deflect toward thearm423 such that theinner edges427 are adjacent an outer surface of thecentral portion413. In such a configuration, theinner surfaces414,415 of theends411,412 may be adjacent outer surfaces of thearms423,424. The same may substantially be true forhole421 andprotrusions426A, except that theouter surface416 of theend411 of theaxle410 may first come into contact with an outer surface ofarm423, and theprotrusions426A may deflect inward (i.e., toward arm424).
• The portion of the[0105]arm423,424 not defining thehole421,422 and/orprotrusions426A,426B may be configured to be rigid enough such that thearm423,424 does not substantially bend or deflect while theprotrusions426A,426B may bend or deflect as theend411 of theaxle410 is placed through thehole421,422. For example, the portion of thearm423,424 not defining thehole421,422 may be thicker than theprotrusions426A,426B. The base425 may also be configured to be more rigid than thearms423,424, for example, so as to not substantially bend or deflect, whileprotrusions426A,426B may bend or deflect as theend411 of theaxle410 is placed through thehole421,422. In another example, the portion of thearm423,424 not defining thehole421,422 and/orprotrusions426A,426B may not have any particular configuration or rigidity such that thearm423,424 does not substantially bend or deflect while theprotrusions426A,426B bend or deflect as theend411 of theaxle410 is placed through thehole426A,426B. For example,arms423,424 may have roughly the same thickness, rigidity, and/or metallic properties as the rest of theclevis assembly420. In such a case, tooling may be used to prevent deflection of thearm423,424. For example, thearm423,424 may be placed between grippers, vices, or any other suitable tooling known in the art so as to substantially prevent deflection of thearm423,424 in a direction substantially perpendicular to the surface of thearm423424 and/or substantially parallel to the longitudinal axis of the axle410 (e.g., when theend411 of theaxle410 is placed through thehole421,422 and exerts force on theprotrusions426A,426B).
• In various embodiments, each arm of the clevis may define a hole with protrusions configured to deflect and then return to its original configuration as an axle is placed therethrough, substantially as set forth above. However, in other embodiments, clevis arms may have different configurations. For example, one of the arms may define a hole with protrusions configured to deflect and then return to its original configuration as an axle is placed therethrough, however, the other arm may define a hole without protrusions that is otherwise configured to allow an end of an axle to pass through the hole without substantially deflecting any portion of the arm. In such a configuration, one end of the axle may have a small enough size and/or shape to pass through the hole on one of the arms and then deflect the protrusions adjacent the hole on the other arm as the end passes therethrough.[0106]
• There may be several advantages to having a clevis assembly with an axle and clevis configuration according to one of the embodiments set forth herein, for example, FIGS. 19A-19E and[0107]20A-20C. One advantage is the elimination of a rivet and the use of expensive riveting equipment to manufacture the clevis assembly. Another advantage is that the clevis assembly may be assembled quickly and through an automated process. A further advantage is that the axle may be solid and thus less expensive than hollow axles which may be used in other clevis assembly configurations. Yet another advantage is that the axle may not include sharp points or edges that may damage the walls of a working channel of an endoscope through which the clevis assembly may be placed. Still another advantage is that the groove may be accurately and precisely placed on the axle such that when the clevis assembly is assembled and the protrusions on the hole of one of the arms are disposed in the groove, the resulting distance between the arms may be precisely controlled and/or ideally manufactured for the intended use of the clevis assembly.
• In various embodiments, all aspects of the invention set forth herein may be used in conjunction with any medical device, instrument, or procedure, and/or any non-medical device, instrument, or procedure. In addition, one or more of the aspects of the invention set forth herein may be combined in the same device.[0108]
• Other embodiments of the invention will be apparent to those skilled in the art from consideration of the specification and practice of the invention disclosed herein. It is intended that the specification and examples be considered as exemplary only, with a true scope and spirit of the invention being indicated by the following claims.[0109]

Claims (39)

What is claimed is:

1. A medical device comprising:

a handle;

an end effector assembly; and

a member connecting the handle to the end effector assembly,

wherein the end effector assembly includes an end effector having a tang defining a pivot hole,

wherein an edge of the tang proximal to the pivot hole extends within an outer periphery of the tang.

2. The medical device ofclaim 1, wherein the tang is configured to substantially prevent contact between the edge and a channel in which the end effector assembly is configured to extend through, as the end effector pivots about the pivot hole.

3. The medical device ofclaim 1, wherein a section of the tang at the outer periphery adjacent the edge has a smooth surface.

4. The medical device ofclaim 1, wherein a first tang portion extending from the outer periphery to the edge forms less than a 90 degree angle to a second tang portion extending from the outer periphery and defining the pivot hole.

5. The medical device ofclaim 4, wherein the first tang portion and the second tang portion form an approximately zero degree angle.

6. The medical device ofclaim 4, wherein the first tang portion and the second tang portion are substantially parallel.

7. The medical device ofclaim 1, wherein a section of the tang between the outer periphery adjacent the edge and the edge is curved.

8. The medical device ofclaim 1, wherein the edge is substantially sharp.

9. An end effector assembly for a medical instrument, comprising:

an end effector having a tang defining a pivot hole,

wherein an edge of the tang proximal to the pivot hole extends within an outer periphery of the tang.

10. The end effector assembly ofclaim 9, wherein the tang is configured to substantially prevent contact between the edge and a channel in which the end effector assembly is configured to extend through, as the end effector pivots about the pivot hole.

11. The end effector assembly ofclaim 9, wherein a section of the tang at the outer periphery adjacent the edge has a smooth surface.

12. The end effector assembly ofclaim 9, wherein a first tang portion extending from the outer periphery to the edge forms less than a 90 degree angle to a second tang portion extending from the outer periphery and defining the pivot hole.

13. The end effector assembly ofclaim 12, wherein the first tang portion and the second tang portion form an approximately zero degree angle.

14. The end effector assembly ofclaim 12, wherein the first tang portion and the second tang portion are substantially parallel.

15. The end effector assembly ofclaim 9, wherein a section of the tang between the outer periphery adjacent the edge and the edge is curved.

16. The end effector assembly ofclaim 9, wherein the edge is substantially sharp.

17. A clevis assembly for a medical instrument, comprising:

a clevis having a base and a first arm and a second arm extending from the base; and

an axle extending between the first arm and the second arm,

wherein the axle defines a groove in which a portion of the first arm is disposed.

18. The assembly ofclaim 17, wherein the portion is configured to deflect from an original configuration as the axle is placed through the first arm.

19. The assembly ofclaim 18, wherein the portion is configured to substantially return to the original configuration for disposition in the groove.

20. The assembly ofclaim 17, wherein the portion includes a plurality of protrusions defining a hole in the first arm.

21. The assembly ofclaim 20, wherein the protrusions deflect.

22. The assembly ofclaim 17, wherein the second arm defines a hole, and a portion of the axle at an end opposite the groove is configured to prevent passage of the portion of the axle through the hole.

23. A clevis assembly for a medical instrument comprising:

a clevis having a base and a first arm and a second arm extending from the base; and

an axle extending between the first arm and the second arm,

wherein a portion of the first arm is configured to deflect from an original configuration and return to the original configuration as the axle is placed through the first arm.

24. The clevis assembly ofclaim 23, wherein the axle includes end portions having cross-sectional sizes larger than a hole defined by the portion of the first arm.

25. The clevis assembly ofclaim 23, wherein the portion includes a plurality of protrusions defining a hole in the first arm.

26. The clevis assembly ofclaim 25, wherein the protrusions deflect.

27. A medical instrument comprising:

a handle portion;

an end effector assembly; and

an elongate member connecting the handle portion to the end effector assembly,

wherein the end effector assembly includes a clevis having a base and a first arm and a second arm extending from the base, and an axle extending between the first arm and the second arm,

wherein the axle defines a groove in which a portion of the first arm is disposed.

28. The medical instrument ofclaim 27, wherein the portion is configured to deflect from an original configuration as the axle is placed through the first arm.

29. The medical instrument ofclaim 28, wherein the portion is configured to substantially return to the original configuration for disposition in the groove.

30. The medical instrument ofclaim 27, wherein the portion includes a plurality of protrusions defining a hole in the first arm.

31. The medical instrument ofclaim 30, wherein the protrusions deflect.

32. The medical instrument ofclaim 27, wherein the second arm defines a hole, and a portion of the axle at an end opposite the groove is configured to prevent passage of the portion of the axle through the hole.

33. A medical instrument comprising:

a handle portion;

an end effector assembly; and

an elongate member connecting the handle portion to the end effector assembly,

wherein the end effector assembly includes a clevis having a base and a first arm and a second arm extending from the base and an axle extending between the first arm and the second arm,

wherein a portion of the first arm is configured to deflect from an original configuration and return to the original configuration as the axle is placed through the first arm.

34. The medical instrument ofclaim 33, wherein the axle includes end portions having cross-sectional sizes larger than a hole defined by the portion of the first arm.

35. The medical instrument ofclaim 33, wherein the portion includes a plurality of protrusions defining a hole in the first arm.

36. The medical instrument ofclaim 35, wherein the protrusions deflect.

37. A method of manufacturing an end effector assembly of a medical instrument, the method comprising:

providing a clevis having a base and a first arm and a second arm extending from the base;

providing an axle;

placing an axle through the second arm;

placing the axle through the first arm so as to deflect a portion of the first arm; and

returning the portion of the first arm to its original configuration.

38. The method ofclaim 37, further comprising placing the portion of the first arm in a groove on the axle..

39. The method ofclaim 37, further comprising providing an end effector; and

placing the axle through a portion of the end effector.

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